NY State Workers' Comp Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) prior authorization requirements (2026)
What NY State Workers' Comp generally requires to approve Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) (CPT 64633, 64634, 64635, 64636), for Workers Compensation (NY) plans. Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) (CPT 64633, 64634, 64635, 64636). Confirm with NY State Workers' Comp, as this can vary by plan.
Medical-necessity criteria NY State Workers' Comp generally applies
Same NY WCB MTG framework. Radiofrequency ablation for a work-related spine injury is adjudicated against the Neck Injury / Mid and Low Back Injury MTGs and the Non-Acute Pain MTG rather than a Medicare LCD. MTG-consistent care needs no PAR; exceeding guideline duration/frequency requires a Variance PAR (30 calendar days). PER-PROCEDURE MTG THRESHOLDS NOT YET EXTRACTED. [NEEDS CLINICAL SPOT-CHECK - framework sourced, thresholds pending]
Commonly required documentation
- MTG-consistency documentation
- prior diagnostic block results
- objective functional measures
- variance rationale where applicable.
How to submit
- Method: Submit through OnBoard, the WCB online system, via the Medical Portal using Board-assigned NY.gov credentials. Paper/fax PARs are not the pathway.
- Portal: OnBoard (NYS WCB Medical Portal)
- Typical turnaround: about 8 days
Sources & verification
- BindingSource — Medical Treatment Guidelines - overview, PAR types and response deadlines (MTG Confirmation 8 business days; Variance 30 calendar days; Special Services 30 calendar days) · effective 2022-05-02.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-08-10.
Frequently asked questions
Does NY State Workers' Comp require prior authorization for Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s)?
Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) (CPT 64633, 64634, 64635, 64636). Confirm with NY State Workers' Comp, as this can vary by plan.
What does NY State Workers' Comp require to approve Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s)?
Same NY WCB MTG framework. Radiofrequency ablation for a work-related spine injury is adjudicated against the Neck Injury / Mid and Low Back Injury MTGs and the Non-Acute Pain MTG rather than a Medicare LCD. MTG-consistent care needs no PAR; exceeding guideline duration/frequency requires a Variance PAR (30 calendar days). PER-PROCEDURE MTG THRESHOLDS NOT YET EXTRACTED. [NEEDS CLINICAL SPOT-CHECK … Always confirm against the current NY State Workers' Comp policy.
How long does a NY State Workers' Comp prior authorization take?
NY State Workers' Comp typically decides Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) requests in about 8 days. Timeframes vary; check the payer portal.
Submitting Radiofrequency Ablation, Paravertebral Facet Joint Nerve(s) to NY State Workers' Comp?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.